ARTICLE Medical Science...7Medical Intern, collage of Medicine, King Faisal University, Alahsa,...

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ANALYSIS

Knowledge, awareness, and attitudes of

population in Eastern Province during outbreak

of novel coronavirus (COVID-19)

Eman Elsheikh1, Hassan H. Alhamoud2, Ahmed Z. Alkhars3, Abdullah I.

Albeladi4, Norah F. AlEid5, Ahmad A. Almuhanna6, Fatimah M. Alabdulmuhsin7,

Mohammed A. Alabdullah8

1Department of Internal Medicine, college of Medicine, King Faisal University, Alahsa, Saudi Arabia, Email:

[email protected]

2Medical Intern, collage of Medicine, King Faisal University, Alahsa, Saudi Arabia, Email: [email protected]







Corresponding author:

Eman Elsheikh, Assistant professor of Cardiology, Internal Medicine Department, College of Medicine, King Faisal University, Alahsa,

Saudi Arabia

IP Phone [Direct]: +966-13-589-7871

Mobile: +966-544709634

Email: [email protected]

https://orcid.org/0000-0002-3150-7125

Article History

Received: 11 August 2020

Reviewed: 12/August/2020 to 11/September/2020

Accepted: 12 September 2020

E-publication: 19 September 2020

P-Publication: September - October 2020

Citation

Eman Elsheikh, Hassan H. Alhamoud, Ahmed Z. Alkhars, Abdullah I. Albeladi, Norah F. AlEid, Ahmad A. Almuhanna, Fatimah M.

Alabdulmuhsin, Mohammed A. Alabdullah. Knowledge, awareness, and attitudes of population in Eastern Province during outbreak

of novel coronavirus (COVID-19). Medical Science, 2020, 24(105), 3494-3505

ANALYSIS 24(105), September - October, 2020

Medical Science ISSN

2321–7359 EISSN

2321–7367

mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://orcid.org/0000-0002-3150-7125


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Publication License

This work is licensed under a Creative Commons Attribution 4.0 International License.

General Note

Article is recommended to print as color digital version in recycled paper.

ABSTRACT

Objective: Coronavirus disease (COVID-19) has been declared a pandemic. The current study aimed to assess public’s knowledge,

perception, and attitude during COVID-19 outbreak. Methods: An online survey was administered during the rapid outbreak of

COVID-19 in Saudi Arabia. Questions focused on the signs, symptoms, transmission, prevention, and control of COVID-19. In

addition, the attitudes and practices of the participants were explored. Descriptive statistics, t-test, and one-way analysis of variance

(ANOVA) which followed by Tukey post-hoc test was conducted. Results: 2453 respondents participated in this study. 90.6% of them

represent eastern of Saudi Arabia. Most of them had good knowledge about COVID-19. Better knowledge was among female,

attitude improve significantly with age and knowledge was significantly higher among higher educational level. The practices of

wearing a mask (80.6%) and keeping a safe distance from people in public places (82.5%) were common among the participants.

Conclusion: Participants demonstrated good knowledge, optimistic attitudes, and practices toward most aspects of the COVID-19

outbreak. Suggesting that governmental efforts of health education about COVID-19 is helpful and important to control the disease.

Key words: Knowledge, Attitude, Practice, COVID-19, Saudi Arabia

1. INTRODUCTION

In December 2019, outbreaks of coronavirus disease (COVID-19) occurred in Wuhan, China. From which it spread explosively to

threaten numerous countries around the world (Perlman, 2020) and soon declared a global pandemic (Zhu et al., 2020). (COVID-19)

is a highly infectious disease caused by a novel coronavirus (2019-nCoV) from the family Orthocoronavirinae. It contains an

enveloped, single-strand RNA on its surfaces, and distinctive "crown-like" spikes (Huang et al., 2020: Munster et al., 2020). COVID-19

belongs to the Extreme Acute Respiratory Syndrome (SARS-COV) family of viruses and to the Middle East Respiratory Syndrome

(MERS-COV). It is stated to be more infectious, but does not fully understand its pathogenesis (Munster et al., 2020). COVID-19's

most important encoded structural protein is the Spike Glycoprotein (S) (Wu et al., 2020: WHO-director 2020) consisting of three S1-

S2 heterodimers binding to an angiotensin-converting enzyme 2 (ACE2) receptor on pneumocyte type II (WHO situation report 70:

World meter 2020).

In the kingdom of Saudi Arabia, the ministry of health (MOH) reported the first case of 2019-nCoV infection on March 2, 2020 in

a citizen who returned via the Kingdom of Bahrain from Iran. By May 31, 2020, the total number of confirmed cases reached up to

85,261 cases, including 22,316 active cases (MOH report 2020: MOH report 2020).

Manifestations of COVID-19 usually start with non-specific symptoms including fever, dry cough, and fatigue. The disease can

progress rapidly to acute respiratory distress syndrome (ARDS), (Perlman, 2020). Older Patients or those with chronic medical

conditions such as heart, lung, kidney, liver diseases and immunosuppressed patient such as diabetic and cancer patients have

higher risk of mortality due to organ failure within a short period of time (Yang et al., 2020).

To date, there is no approved vaccination or standard treatment of COVID-19. It is essential to prevent further spread of the

disease by following the preventive measures such as social distancing, proper hand hygiene and the use of facemask. These

measures have been encouraged by governments, MOH, physicians and celebrities to avoid any kind of gathering including sports,

religious ceremonies and attending classes in schools (McCloskey et al., 2020).

Awareness and attitude of the public are essential for the adherence to the social protection measures and eventually on the

clinical outcomes (Roy et al., 2020). Previous lessons learned during the 2003 SARS outbreak indicate that attitudes towards

infectious diseases are correlated with the degree of fear among people, which may complicate further attempts to prevent the

spread of the disease (Hung, 2003).


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The increase in numbers which is dependent on multiple contributing factors such as life style practices and behaviors,

underestimation the seriousness of the disease and its effect combined by the low measures followed by people with low

knowledge about it, making the battle in fighting such an infection complicated (Zhong et al., 2020: Wu et al., 2020).

Our study aimed to assess awareness, practice and attitude of a community and the potential risk patients for COVID-19

infection to ultimately lower burden and reduce new cases instead of wasting time and resources on non-beneficial approaches.

2. METHODS

Study design and population

An observational cross-sectional study was conducted using survey instrument to obtain responses from the general population

who are 18 years and older living in Saudi Arabia. As result of the current circumstances of social distancing, a suitable tool that’s

achieved a minimal contact was used to collect the data needed in this study, and it was an online Google form questionnaire

distributed through the use of different types of social media apps including What’s up, Twitter and Telegram.

Survey Tool, Instrument, Dissemination and Validation

The survey questionnaire was designed in Arabic, as it is the native language in Saudi Arabia. This study generally assesses the

knowledge, perception, and attitude towards protective measures against COVID 19. The survey consist of 23-items were developed

and published during the period between May 2020 and June 2020 with 2,453 responses. Some of those items has been conducted

and validated by the Regional Office for Europe of the World Health Organization. A minor modification was made as required to

facilitate better comprehension and to organize the questions before the final survey was distributed to the population via Google

link to the whole kingdom of Saudi Arabia focusing, especially on the eastern province.

The survey may take approximately 3-4 minutes to be completed. The 23-item questionnaire was divided into six parts:

participant characteristics (7 items), awareness of COVID-19 (7 items), source of information (1 item), knowledge about symptoms of

COVID-19-affected patients (1 item), different modes of transmission (2 items), precautions and risk prevention (3 items). Knowledge

and perception were assessed by questions focusing on COVID-19 signs and symptoms, transmission, high risk group and risk

prevention.

Sample

The sample size that Google form shows was 2,453 responses with margin of error of 5% and 95% confidence interval. A minimum

2000 responses were required for the study.

Validation of the Study

For validation purposes the questionnaire was first proposed to three experts in the field of research to check if the questions in the

questionnaire adequately measure knowledge and attitude toward COVID-19. After that the questionnaire was pretested by

distributing the questionnaire on 20 participants who were excluded from the study later. The internal consistency of these data

from these questionnaires was assessed using Cronbach’s alpha. The result showed appropriate internal consistency (Cronbach’s

alpha = 0.82).

Statistical Analysis

Microsoft Excel was used for data cleaning and management. After management, data were exported to Statistical Packages for

Social Sciences (SPSS) version 23 analysis. Descriptive statistics were presented using frequency and percentages for categorical

variables and continuous variables were summarized using means ± standard deviations. The associations of knowledge and

attitudes scores with socio-demographic characteristics of participants were tested using independent t-test and ANOVA test.

ANOVA tests were followed by Tukey post-hoc test to determine where the exact difference between subgroups exists. Level of

significance was set at 0.05.

3. RESULTS

Two thousand, four hundred and fifty-three participants from different areas in Saudi Arabia completed the survey. Table 1 displays

the demographical data of the participants. The gender contribution of the participants was nearly equal (50.1%) by males and

(49.9%) for females. For the age distribution, the largest proportion of the participants were between 18-39 years (59%) followed by

those between 40-60 years (35.6%) and the least responses (1.9%) came from participants aging 60 years and more. Only 89 (3.60%)

were non-Saudi. As regard to educational level, most of the participant had an education higher than school level. 1020 (41.6%) had


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a non-health related bachelor's degree. On the other hand, 544 (22.2%) had a high school education while 174 (7.10%) had primary

education. As for place of residency, 2222 (90.60%) were from the eastern region of Saudi Arabia, the rest were from central region,

western region, and other regions of Saudi Arabia.

Table 1 Socio-demographical Profile of The Participants (n =2453)

Demographical Characteristics n %

Gender

Male 1230 50.10

Female 1223 49.90

Age

Less than 18 85 3.50

18 – 39 Years 1448 59.00

40 – 60 Years 873 35.60

More than 60 47 1.90

Nationality

Saudi 2364 96.40

Non-Saudi 89 3.60

Educational Level

Primary 174 7.10

Highschool 544 22.20

Diploma 284 11.60

Bachelor (non-health related) 1020 41.60

Bachelor (Health related) 346 14.10

High Education (Master/PhD) 85 3.50

Place of Residency

Eastern Region 2222 90.60

Central Region 105 4.30

Western Region 37 1.50

Other 89 3.60

Where have you been working during the lockdown period?

I don’t Work 1557 63.50

Health practitioner 139 5.70

I work out of home and I make contact with many people 176 7.20

I work out of home and I make contact with few people 215 8.80

I work in home (online) 366 14.90

Have you traveled to any country affected by the outbreak of the novel corona virus (COVID-19) in the last few

months?

Yes 73 3.00

No 2380 97.00

Have you heard about the symptoms of the novel corona virus (COVID-19) and its preventive measures?

Yes 2120 86.40

No 81 3.30

I heard about the symptoms only 176 7.20

I heard about the preventive measures 76 3.10

Risk Assessment of Participants (Based on Chronic disease & Medication)?

Low Risk Group 1953 79.60

High Risk Group 500 20.40


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When asked about where they have been working a variety of responds was observed. Most did not work 1557 (63.5%), 366

(14.9%) worked in home, 139 (4.7%) were health practitioner and the rest worked out of home. 73 (3%) had been in a country

affected by the pandemic.

Most participants 2120 (86.40%) claimed that they had heard about COVID-19. The most stated sources of knowledge were

social media and health workers (75.6%) and (55.1%) respectively, followed by personal efforts (20.9%), attending gathering courses

(13.4%), (Figure 1).

Regarding risk of having COVID-19 based on the presence of chronic diseases and/or usage of medication associated with

increased risk and severity of infection, most of our participants did not have any chronic disease. 500 (20.4%) were categorized as

high risk of increase the severity or risk of having COVID-19 based on the presence of chronic diseases and/or usage of medication

associated with increased risk and severity of infection. The most prevalent diseases were hypertension (7.3%) and diabetes mellitus

(6.8%). Regarding medication usage of the participants, the vast majority (87.9%) did not use any medication, (2.1%) used

immunosuppressants or cortisol containing medications and (0.4%) were using chemotherapy.

Figure 1 Sources of information reported by participants

Results of knowledge assessment of the participants regarding incubation period of corona virus, its survival on surfaces, ways

of spread and safe distance that reduce transmission of disease are shown in Table 2. Considering participants' knowledge about

common symptoms of corona virus, fever (96.8%), shortness of breath (89.5%) and dry cough (84.7%) were the most thought of as

symptoms of COVID-19. With (6.2%) have wrongfully identified cough with blood as a symptom of COVID-19. The 3 most correctly

identified preventive measures were staying in home (94.9%), continuously disinfecting hands (90.5%) and wearing a facemask

(8.3%), (Figure 2).

Table 2

Participant Responses Toward Knowledge Questions

n %

Q1/ What is the incubation period of the virus (the period of time between catching the virus and the appearance of

symptoms/ contagious phase?)

3 days or less 89 3.6

A week 120 4.9

Up to two weeks (Correct Answer) 2028 82.7

I don’t know 216 8.8

Q2/ Does the novel corona virus (COVID-19) live on surfaces for long time?

Yes 1137 46.4

No (Correct Answer) 916 37.3


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I don't Know 400 16.3

Q3/ Can the novel corona virus (COVID-19) spread through touching things like money?

Yes (Correct Answer) 2024 82.5

No 224 9.1

I don't Know 205 8.4

Q4/ What is the safe distance that reduces the chances of transmitting the corona virus from an infected person to a

healthy person?

Less than one meter 63 2.6

from 1 – 2 meters (Correct Answer) 2227 90.8

3 meters and more 163 6.6

Figure 2 Participants Perception toward Practices that prevent COVID-19

The attitude of the participants towards the preventive measures to limit the spread of COVID-19 and their responses are

presented in Table 3. The overall attitude was positive for most of the practices of the inquired preventive measures. The most

common reason for leaving home during the pandemic was getting supplies (61.8%), (Figure 3).

Table 3

Participant Responses Attitude Questions

n %

Q1/ Do you leave home?

Yes 1137 46.4

No 916 37.3

Rarely, when necessary 400 16.3

Q2/ When you leave home, which of the following do you regularly practice?

Wearing a face mask. 2035 83


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Washing and disinfecting hands continuously and after touching surfaces 2133 87

Keeping a safe distance from others 2103 85.7

Avoiding touching nose, mouth and eyes when hands are not clean 2040 83.2

I don’t practice any of the previously mentioned measures 58 2.4

Q3/ Assess your practice Toward the following: Using hand sanitizer when you are out of home?

Always 1382 56.3

Sometimes 846 34.5

Never 225 9.2

Q4/ Assess your practice Toward the following: Using tissues when coughing or sneezing

Always 1628 66.4

Sometimes 747 30.5

Never 78 3.2

Q5 Assess your practice Toward the following: Using your forearm to cover your mouth when sneezing or coughing when there

are no tissues.

Always 1714 69.9

Sometimes 632 25.8

Never 107 4.4

Q6/ Assess your practice Toward the following: Immediate disposal of used tissues by throwing it in trash can.

Always 2200 89.7

Sometimes 246 10

Never 7 0.3

Q7/ Assess your practice Toward the following: Avoiding touching nose and eyes.

Always 1602 65.3

Sometimes 803 32.7

Never 48 2

Q8/ Assess your practice Toward the following: Wearing face masks when leaving home or in gathering/crowded places.

Always 1976 80.6

Sometimes 402 16.4

Never 75 3.1

Q9/ Assess your practice Toward the following: Wearing gloves when leaving home.

Always 1034 42.2

Sometimes 1039 42.4

Never 380 15.5

Q10/ Assess your practice Toward the following: Keeping a safe distance from people in public places?

Always 2023 82.5

Sometimes 412 16.8

Never 18 0.7

Q11/ Assess your practice Toward the following: Avoiding handshakes and cheek kisses when greeting people.

Always 2073 84.5

Sometimes 337 13.7

Never 43 1.8

Q12/ Assess your practice Toward the following: Disinfecting surfaces continuously like door knobs.

Always 915 37.3

Sometimes 1157 47.2

Never 381 15.5

Q13/ Assess your practice Toward the following: Disinfecting personal belongings (like phones, keys) continuously

Always 958 39.1

Sometimes 1067 43.5

Never 428 17.4

Q14/ Assess your practice Toward the following: Avoiding home visits and avoiding gathering as much as possible.


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Always 1748 71.3

Sometimes 641 26.1

Never 64 2.6

Q15/ Assess your practice Toward the following: Maintaining personal hygiene.

Always 2375 96.8

Sometimes 73 3

Never 5 0.2

Q16/ Assess your practice Toward the following: Maintaining healthy diet.

Always 1785 72.8

Sometimes 617 25.2

Never 51 2.1

Figure 3 Reported Causes of Leaving Home among participants

Table 4

Knowledge & Attitude Scores and Classification

Variable Measures

Scores Mean SD

Knowledge Score (Total = 22) 17.0057 2.97

Attitude Score (Total = 33) 26.9095 4.51

Knowledge Classification n %

Low Knowledge Level 155 6.30

Moderate Knowledge Level 647 26.40

High Knowledge Level 1651 67.30

Attitude Classification n %

Low Attitude Level 83 3.40

Moderate Attitude Level 713 29.10

High Attitude Level 1657 67.50

Table 4 shows the knowledge and attitude scores and levels. The Mean score for knowledge was 17 (Total = 22) and the mean

score for attitude was 26.91 (Total = 33). As for the knowledge and attitude level, 1651 (67.30%) had a high knowledge level and

1657 (67.50%) had a high attitude level. Low level of knowledge was found only in 155 (6.3%) and low level of attitude was found

only in 83 (3.4%).


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Table 5 Association of Socio-demographical Profile of The Participants with Knowledge & Attitude Scores (n =2453)

Demographical Characteristics Knowledge Attitude

Gender p = 0.062 p < 0.001*

Male 17.11 +/= 2.90 26.2 +/- 4.48

Female 16.89 +/- 3.02 27.62 +/- 4.43

Age p = 0.969 p = 0.001*

Less than 18 17.09 +/- 2.67 26.23 +/- 4.8

18 – 39 Years 17.02 +/- 2.94 26.68 +/- 4.66

40 – 60 Years 16.97 +/- 2.98 27.26 +/- 4.19

More than 60 16.98 +/- 3.81 28.36 +/- 2.86

Educational Level p < 0.001* p = 0.105

Primary 16.17 +/- 3.39 27.5 +/- 4.98

Highschool 16.64 +/- 3.08 26.49 +/- 4.98

Diploma 16.74 +/-3.22 26.94 +/- 4.26

Bachelor (non-health related) 17.07 +/- 2.92 26.92 +/- 4.38

Bachelor (Health related) 17.88 +/- 2.28 27.19 +/- 4.21

High Education (Master/PhD) 17.6 +/- 2.5 26.95 +/- 3.72

Risk Assessment of Participants (Based on Chronic disease & Medication) p = 0.94 p = 0.361

Low Risk Group 16.98 +/- 2.99 26.91 +/- 4.54

High Risk Group 17.11 26.9 +/- 4.39

Level of Knowledge

-

p < 0.001*

Low Knowledge Level 25.44 +/- 5.18

Moderate Knowledge Level 26.63 +/- 4.67

High Knowledge Level 27.16 +/- 4.35

* Significant at level 0.05.

The relation between socio-demographic characteristics and knowledge about COVID-19 is demonstrated in Table 5. Females

have a significant higher score in their attitude, while no significant difference between gender in knowledge scores. When

comparing scores across age groups, older group were significantly higher in attitude scores. Tukey Post-hoc test revealed the

presence of significant difference in attitude between those older than 60 compared to those younger than 18 (p = 0.048) and

between those between 40 – 60 years and those between 18 – 39 (p = 0.014) in favor for the older group in both comparisons. On

the other hand, no significant difference in knowledge score was noted across age groups. As regard educational level, a significant

difference in knowledge score is present between those with primary education and those with (Bachelor non-health related p =

0.003, bachelor health related p < 0.001 and high education p = 0.004) in favor to the second groups. A significantly higher level of

knowledge scores was also noted to the favor of health-related bachelor when compared to (high school, diploma, and non-health

related bachelor) all with p < 0.001. However, no significant difference was present in attitude scores. It has also been noticed that

there is a significant difference in attitude scores across the different knowledge levels (p < 0.001). Post-hoc test demonstrated a

significant difference in attitude between high knowledge level and (low level of knowledge p < 0.001 and moderate level of

knowledge p = 0.03) also between moderate level of knowledge and low level of knowledge (p = 0.009), all in favor of the higher

level of knowledge. No significant difference was observed neither in attitude nor in knowledge scores across nationality and risk

groups (based on chronic diseases and medication usage).

4. DISCUSSION

Saudi Arabia considered one of the largest countries in the Middle East region of more than 34 million people (World meter 2020). It

is the highest populated country within the Gulf region. Hence, the risk of spread of infection is high, especially among high-risk

group of people (Abdelhafiz et al., 2020). Up till now, no vaccine or treatment proved and available. So, prevention is the best


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solution. Huge effort has provided from all ministries particularly the Ministry of Health. Since it is crucial to adhere to the preventive

protocols, knowledge, and attitude are of upmost importance to be studied to guide the efforts of different authorities (Azlan et al.,

2020). Here our study aims to measure and evaluate the knowledge, attitude, and practices of population in Saudi Arabia,

particularly in the eastern province.

Knowledge and perception

In general, most participants in this study are knowledgeable about the disease, its symptoms, preventive measures, incubation

period and its transmission. Most notably, the perception of those who are at high risk of being affected and the relation of COVID-

19 and their chronic diseases or medications they are receiving. This is a good indicator of a positive impact to involve the public in

fighting COVID-19 (Sima et al., 2020). The average knowledge score was 17 out of 22 ~ (77.2%). in comparison to other scores in

other similar studies that have been conducted in Saudi Arabia in western region (81.64%), China (70.2 to 98.6%) and Malaysia

(80.5%), (Abdelhafiz et al., 2020: Azlan et al., 2020: Zhong et al 2020). In contrast to other studies conducted in other countries,

nearly half of the Bangladesh population is not aware enough of COVID-19 and the common dangerous situation (Haqueet al.,

2020). When asking our participant about the source of their knowledge, internet represented the most important sources of

information 75.6% followed by healthcare workers 55.1%. This is best interpreted by the large proportion of the participants (59%)

being around 18-39 years of age, who are more likely to use the internet and social media platforms. This finding is like other study

conducted In Iran where most people acquire their knowledge from social media (Kakemam et al., 2020). It is important to

remember that the Saudi Arabian MOH started working with the media in taking early actions by encouraging the public in

following the preventive measures (Al-Hanawi et al., 2020). Despite the efforts done by MOH and availability and easy accessibility of

obtaining the information through different platforms, they can also be a source of misunderstanding and false information. Around

46.4% of the participant thought that the virus can live for long period of time on the surfaces; while 16.3% answered I do not know.

Large numbers of our participants are aware about the most important preventive measures such as staying at home; disinfect the

hands and wearing a mask although some considered that consuming garlic and herbal tea can be a preventive measure as well.

Again, this illuminates the drawback of using social media platforms as a source of information. And it is also indicating that

information overload can lead to confusion and difficulty in finding the correct answer (Azlan et al., 2020). This emphasizes the

Importance of fighting the rumors and false information regarding these aspects.

Attitude

This study showed that most of the participants held positive attitude toward the preventive measures of COVID-19 that reduce risk

of transmission. Most of the participant wear mask when going outside, disinfect their hands, keep safe distance from others and

avoid touching their faces. Only 2.4% state that they do not practice any of these. Overall, the average attitude score is 27 out 33 ~

(82%) and 67.50% of the participants had high attitude level, while only 3.4% showed low attitude level. High attitude levels also

were reported in other similar studies conducted in Saudi Arabia, China, and Malaysia (Azlan et al., 2020: Zhong et al 2020: Al-

Hanawi et al., 2020).

On similar study conducted in Saudi Arabia the participants showed positive attitude toward COVID-19 with average score of

28.3 out of 30 (94%), (Al-Hanawi et al., 2020). However, in this current study lower attitude level with score of 26.9 out 33 (81.5%)

were seen and this can be explained by the rapid increase in number of reported cases in Saudi Arabia and my indicate that there is

decline in attitude levels.

Association of demographic factors and KAP towards COVI-19

Results of other studies reported that older participants and females are more knowledgeable about the emerging communicable

diseases (Al-Mohrej et al., 2020). In fact, this study results show no association between the gender and the age group of the

participant when talking about the knowledge. When dividing the level of knowledge into different levels, high, moderate, and low.

There is clear association between participants’ knowledge and their level of education. Higher level of knowledge was noted to be

in favor of participant with a health-related bachelor when compared to high school, diploma, and other non-health related

bachelor. This is probably due to better background on medical sciences among participants with a health-related studies. In

agreement of this study, other studies found similar findings, as higher knowledge score was found to be greatly associated with

positive attitude towards the preventive measures (Zhong et al 2020: Huynh et al., 2020: Alahdal et al., 2020). Since most participants

have education higher than school level, this has been reflected on their adherence to the protective measures. These findings

clearly indicate the importance of improving residents’ knowledge about COVID-19 via health education, which can improve their

attitudes and practices towards COVID-19 (Zhong et al 2020).


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The result of this study showed that women are having higher attitude levels toward the preventive measures than men (p <

0.001) and was reported on similar studies conducted in china, Riyadh, western of SA, and Bangladesh (Zhong et al 2020: Haque et

al., 2020: Al-Hanawi et al., 2020: Alahdal et al., 2020). This can be explained by the different activities related to gender in the

practice and family responsibilities (Alahdal et al., 2020). There is significant relationship between age and attitude levels (p < 0.001)

older people have higher attitude levels and this also was found on similar studies conducted in Saudi Arabia (Al-Hanawi et al.,

2020).

Study Strengths and Limitations

The study was conducted by using online Google form and was sent to different media platforms such as WhatsApp, telegram,

twitter. As a result, only people who have access to these platforms had been involved in this study and participation of people with

limited access could affect the result of certain aspects. The tool used to collect the data is self-reported survey and there is

possibility that the population may give socially desirable answers especially on attitude questions because they are expected to

held positive attitude, as they perceive (Mortel, 2008).

5. CONCLUSION

To sum up, the current study revealed good knowledge, positive attitudes, and practices of public toward most aspects of the

COVID-19 outbreak which is very important to limit the spread of disease. However knowledge was lower among less educated and

attitude toward protective measures was lower in younger age. This necessitates more efforts or using different ways to reach to

these groups and communicate with them. Such assessment survey is important for ensuring that the general public is well informed

in a condition like COVID-19 outbreak and directing efforts of health education towards the needy group. Hopefully, with combined

efforts of Ministry Of Health and all residents, Saudi Arabia surely will win the battle against COVID-19 nearly.

Acknowledgements

The authors thank all the participants involved in this study for their cooperation and support.

Author contribution

Eman Elsheikh: Conception, design, data interpretation and review, Hassan H. Alhamoud: Data collecting, writing, Ahmed Z. Alkhars:

Statistical analysis, Abdullah Albeladi: Data collecting, writing and review, Norah F. AlEid: Data collecting, writing, Ahmad A.

Almuhanna: Data collecting, Writing, literature review, Fatimah M. Alabdulmuhsin: Data collecting, writing, Mohammed A.

Alabdullah: Data collecting and analysis

Informed consent

Written & Oral informed consent was obtained from all individual participants included in the study. Additional informed consent

was obtained from all individual participants for whom identifying information is included in this manuscript.

Competing interests

Authors declare, No conflict of interest.

Funding Statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethics approval and consent to participate

This study was approved by the Ethics Committee of King Fahd Medical City. Before filling the survey, and according to Helsinki

declaration, there was a statement that declares that Participant's secrecy and privacy were guaranteed. Submission of complete

answered survey was considered as agree to share in the study (Ethical approval code: 20-368E).

Data and materials availability

All data associated with this study are present in the paper.

Peer-review

External peer-review was done through double-blind method.


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RREEFFEERREENNCCEESS AANNDD NNOOTTEESS

1. Perlman S. Another decade, another coronavirus. N Engl J

Med 2020; 382:760-2.

2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from

patients with pneumonia in China, 2019. N Engl J Med 2020;

382:727-33.

3. Huang C, Wang Y, Li X, et al. Clinical features of patients

infected with 2019 novel coronavirus in Wuhan, China.

Lancet 2020; 395:497-06.

4. Munster VJ, Koopmans M, van Doremalen N, van Riel D, de

Wit E. A novel coronavirus emerging in China - key

questions for impact assessment. N Engl J Med 2020;

382:692-4.

5. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An

overview. J Chin Med Assoc. 2020;83(3):217-20.

6. World Health Organization. WHO Director-General's

opening remarks at the media briefing on COVID-19 - 11

March 2020 URL: https://www.who.int/dg/speeches/detail/

who-director-general-s-opening-remarks-at-the-media-

briefing-on-covid-19--11-march-2020

7. WHO, 2020d. Coronavirus Disease 2019 (COVID-19)

Situation Report – 70

8. World meter. COVID-19 coronavirus outbreak. Accessed at

www.worldometers.info/coronavirus on 24 March 2020

9. Ministry Of Health. MOH Reports First Case of Coronavirus

Infection. 02 March 2020. URL: https://www.moh.gov.sa

/en/Ministry/MediaCenter/News/Pages/News-2020-03-02-

002.aspx

10. Ministry Of Health. MOH: 1,877 New COVID-19 Cases

Reported, Recoveries Surpass 62,000. 31May 2020. URL:

https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pa

ges/News-2020.

11. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, Ji R, Wang H,

Wang Y, Zhou Y. Prevalence of comorbidities in the novel

Wuhan coronavirus (COVID-19) infection: a systematic

review and meta-analysis. Int J Infect Dis,2020;94:91-5

12. McCloskey B, Zumla A, Ippolito G, Blumberg L, Arbon P,

Cicero A, et al. Mass gathering events and reducing further

global spread of COVID-19: a political and public health

dilemma. Lancet. 2020; 395:1096–9.

13. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V.

Study of knowledge, attitude, anxiety & perceived mental

healthcare need in Indian population during COVID-19

pandemic. Asian Journal of Psychiatry. 2020;51: 1–16.

14. Hung LS. The SARS epidemic in Hong Kong: what lessons

have we learned?. J R Soc Med. 2003;96(8):374-8.

15. Zhong BL, Luo W, Li HM, et al. Knowledge, attitudes, and

practices towards COVID-19 among Chinese residents

during the rapid rise period of the COVID-19 outbreak: a

quick online cross-sectional survey. Int J Biol Sci.

2020;16(10):1745-52.

16. Wu Z, McGoogan JM. Characteristics of and important

lessons from the coronavirus disease 2019 (COVID-19)

outbreak in China: summary of a report of 72 314 cases from

the Chinese Center for Disease Control and Prevention.

JAMA. 2020 ;323(13):1239-42.

17. https://www.worldometers.info/world-population/saudi-ara

bia-population/

18. Abdelhafiz AS, Mohammed Z, Ibrahim ME, Ziady HH, Alorabi

M, Ayyad M, Sultan EA. Knowledge, perceptions, and

attitude of Egyptians towards the novel coronavirus disease

(COVID-19). Journal of Community Health. 2020;1-10.

19. Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E. Public

knowledge, attitudes and practices towards COVID-19: A

cross-sectional study in Malaysia. Plos one. 2020; 15(5):

e0233668.

20. Sima R, Mariam I, Aisha B: Knowledge, attitudes, and

practices (KAP) towards COVID-19: A quick online cross-

sectional survey among Tanzanian residents. medRxiv 2020

21. Haque T, Hossain KM, Bhuiyan MMR, et al. Knowledge,

attitude and practices (KAP) towards COVID-19 and

assessment of risks of infection by SARS-CoV-2 among the

Bangladeshi population: An online cross-sectional survey.

Research Square; 2020.

22. Kakemam E, Ghoddoosi-Nejad D, Chegini Z, Momeni K,

Salehinia H, Hassanipour S, Ameri H, Arab-Zozani M.

Knowledge, attitudes, and practices among the general

population during COVID-19 outbreak in Iran: A national

cross-sectional survey. medRxiv. 2020 Jan 1.

23. Al-Hanawi, M. K., Angawi, K., Qattan, A., & Kattan, W.

Knowledge, Attitude, and Practice toward COVID-19 among

the Public in the Kingdom of Saudi Arabia: A Cross-Sectional

Study. Front Public Health 2020; 8 (217):1-10.

24. Al-Mohrej OA, Al-Shirian SD, Al-Otaibi SK, Tamim HM,

Masuadi EM, Fakhoury HM. Is the Saudi public aware of

Middle East respiratory syndrome? Journal of Infection and

Public Health 2016; 9, 259-66

25. Huynh G, Nguyen TNH, Tran VK, Vo KN, Vo VT, Pham LA.

Knowledge, and attitude toward COVID-19 among

healthcare workers at District 2 Hospital, Ho Chi Minh City.

Asian Pac J Trop Med 2020; 13:3-5.

26. Alahdal H, Basingab F, Alotaibi R. An analytical study on the

awareness, attitude, and practice during the COVID-19

pandemic in Riyadh, Saudi Arabia. Journal of infection and

public health. 2020 Jun 17.

27. Mortel TF. Faking it: social desirability response bias in self-

report research. Aust J AdvNurs. 2008;25(4):40–8.
https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-03-02-002.aspxhttps://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-03-02-002.aspxhttps://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-03-02-002.aspxhttps://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2020-https://www.worldometers.info/world-population/saudi-arabia-population/https://www.worldometers.info/world-population/saudi-arabia-population/

ARTICLE Medical Science...7Medical Intern, collage of Medicine, King Faisal University, Alahsa,...

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